The Claims Supervisor oversees a team of direct reports, ensuring adherence to quality, productivity, and customer service standards while complying with company policies. This role involves supervising daily operations, assisting with staff onboarding, providing technical guidance on complex claims, and acting as a liaison for final claim resolutions.
Remote Jobs & Work From Home Positions in United States (119,919)
Remote in = United States
The Medical Only Claims Specialist manages non-complex, non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision. Responsibilities include receiving claims, confirming coverage, determining compensability, establishing reserves, authorizing payments, and communicating claim status to relevant parties.
The role involves managing and expanding existing customer relationships within the logistics sector while actively developing new sales opportunities. A key function is leveraging the company's capacity team to focus sales efforts on customer growth rather than daily freight execution issues.
The role involves managing and optimizing Microsoft 365 environments, focusing heavily on Entra ID, Conditional Access policies, and device management via Intune. Key duties also include enforcing configuration and security policies across M365 services and remediating vulnerabilities.
Senior Claims Specialist - New England
CorVel Corporation
·
Full Time
·
12 Weeks Ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, and establishing reserves and authorizing payments within authority limits. This role also involves developing action plans with case managers, coordinating return-to-work efforts, managing subrogation and litigation, and ensuring adherence to client and carrier guidelines.
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The Medical Case Manager will provide case management to injured workers through in-person and telephonic communications, utilizing nursing knowledge to discuss and evaluate treatment plans for appropriateness and medical necessity. Responsibilities also include attending provider visits, facility discharge planning, and negotiating the delivery of necessary care services.
The Analyst verifies provider information and processes documentation requests, such as itemized bills and medical records, to audit claims. Responsibilities also include ensuring the accuracy of patient, provider, and client information for proper request delivery.
The Appeals Team Lead assists various stakeholders by locating providers within the Medical Provider Network (MPN), verifying inclusion, and scheduling appointments for injured workers. This role involves managing inbound and outbound calls while documenting bill review errors to improve team performance trends.
The Business Development Manager is responsible for building and strengthening relationships with commercial salespeople and targeted Mechanical Contractors to manage new business development, focusing on generating Daikin VRV Design-Build projects. This role also involves maintaining distributor relationships, determining and executing technical training needs, and conducting extensive market analysis.
The Medical Case Manager will provide in-person and telephonic case management to injured workers, collaborating with patients, physicians, and employers to facilitate recovery. Responsibilities include assessing, planning, implementing, and evaluating treatment plans for appropriateness, medical necessity, and cost effectiveness.
Operators are responsible for setting up and logging into the Hawk-Eye system two hours before the game, conducting pre-game checks, and monitoring camera-based models throughout the game, making necessary adjustments. Post-game duties include reviewing, linking, and uploading data, as well as reporting any hardware or software issues to support staff.
The Account Executive is tasked with interacting with customers and prospects at an executive level to sell new services and ensure clear communication of expectations across all internal teams. Responsibilities include meeting or exceeding sales goals, actively prospecting, and documenting all sales activities in sf.com.
The Case Management Supervisor directs the operations of their designated department, overseeing employees, ensuring quality of service, and handling human resources matters for the supervised department. Responsibilities may also include reviewing various reports, limited sales activities, and potentially overseeing clinical case management activities depending on RN status.
The Claims Supervisor is responsible for overseeing a team of direct reports, ensuring adherence to quality, productivity, and customer service standards while following company policies. This role involves supervising daily operations, assisting with staff onboarding, ensuring regulatory compliance, and providing technical guidance on complex claims issues.
The Advocacy 24/7 Triage Nurse provides telephonic first aid and assessment to injured workers based on national standards to facilitate treatment goals. This involves recommending appropriate providers, educating callers on self-care, communicating the care plan, and documenting clinical assessments concisely.
Advanced Practice Provider - Greenville, SC
Monogram Health
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Full Time
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12 Weeks Ago
Monogram Health
The Advanced Practitioner will deliver personalized, compassionate medical care primarily to patients with CKD and/or ESRD/ESKD through comprehensive annual wellness exams conducted both in-home and virtually. Key duties include documenting patient records, coordinating care with other providers, prescribing medications, and implementing evidence-based treatment plans to reduce hospitalizations.
The Correspondence Team Lead monitors and tracks all processes for the Correspondence Team, including running queries, maintaining reports, and compiling supporting documents for correspondence. This role is also responsible for training new analysts and tracking errors to create coaching measures.
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The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals, aiming to support quality treatment and timely return to work. This involves assessing treatment plan appropriateness, communicating with physicians, and explaining conditions and plans to patients, family members, and adjusters.
The Medical Case Manager provides in-person and telephonic case management to injured workers, collaborating with patients, providers, and employers to facilitate recovery. Responsibilities include assessing treatment plans for appropriateness and necessity, attending provider visits, and coordinating long-term care strategies.
Commercial Lines Client Service Manager - Forestry Team
Higginbotham
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Full Time
·
12 Weeks Ago
Higginbotham
The Client Service Manager assists producers and clients with maintaining commercial lines insurance coverage by processing policies, endorsements, audits, and cancellations. This involves preparing endorsement requests, following up with carriers, processing audits with rate verification, handling cancellations, and communicating with staff and clients as needed.
Commercial Lines Account Manager - Forestry, Logging & Transportation
Higginbotham
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Full Time
·
12 Weeks Ago
Higginbotham
The Commercial Lines Account Manager is responsible for providing prompt, accurate, and courteous service to clients, producers, and company personnel while supporting the maintenance and expansion of commercial accounts. Essential tasks include planning and implementing insurance programs, staying updated on industry changes, negotiating terms with carriers, and preparing necessary documentation like proposals and summaries of insurance.
This role focuses on operational responsibilities centered around user operations and configuration, ensuring accurate user setup and access for both internal and external stakeholders using proprietary software. Responsibilities include managing user accounts, roles, and permissions, troubleshooting related issues, and acting as a liaison between end users and technical teams.
The Director will manage the client performance management team, overseeing customer setup, implementation, training, support, and reporting processes for CareIQ services. This role involves directing the communication strategy for client performance and ensuring service expectations are successfully established and operationalized.
Senior Claims Specialist - West Virginia
CorVel Corporation
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Full Time
·
12 Weeks Ago
CorVel Corporation
The Senior Claims Specialist manages complex Workers' Compensation claims by confirming coverage, determining compensability through investigation, and establishing reserves while authorizing payments within limits. This role involves developing action plans with case managers to reduce claim costs, coordinating return-to-work efforts, managing subrogation and litigation, and ensuring adherence to client and carrier guidelines.
The Account Manager is responsible for executive-level customer interaction, acting as a client extension to understand and communicate expectations, and increasing market share by delivering service that meets or exceeds customer goals. Key duties include managing accounts with significant revenue, conducting client stewardship, handling collections, and driving revenue growth with existing accounts.
Sr. Talent Acquisition Sourcing Specialist
HomeServices of America
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Full Time
·
12 Weeks Ago
HomeServices of America
The role involves full-cycle recruiting and staffing for professional and management positions across the United States, focusing heavily on sourcing active and passive candidates using various channels. Key duties include coordinating the recruitment process, maintaining candidate pipelines, and advising hiring managers on best practices.
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Sr Account Manager, Manchester - Midwest
Clearwater Paper Corporation
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Full Time
·
12 Weeks Ago
Clearwater Paper Corporation
The Sr Account Manager is tasked with developing and executing sales activities within a defined geographic market to meet established sales and profitability objectives, which includes direct account management and channeled growth aligned with company vision. This role involves establishing business plans and strategies, collaborating with sales leadership, and contributing to training programs for customers and internal staff.
The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals to support quality treatment and timely return to work. This involves assessing treatment plans, communicating with physicians, and coordinating care delivery such as negotiating durable medical equipment.
The Nurse Practitioner will conduct comprehensive annual wellness exams for patients both in-home and virtually, delivering personalized, compassionate medical care primarily to individuals with CKD and/or ESRD/ESKD. Responsibilities also include documenting patient information, coordinating care with other providers, prescribing medications, ordering tests, and ensuring timely completion of all required paperwork.
The role involves leading the design and technical execution of the Enterprise Performance Management (EPM) ecosystem, acting as the primary authority on the OneStream unified platform. Key duties include defining architectural strategy, overseeing multi-cube design, and hands-on development of complex business rules and data integrations.
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